This week a man over 50 years of age came in with complaints of increased frequency of urination along with increasing hesitancy, urgency, and poor urinary stream.  He states that urgency is getting so bad that he often fears he'll lose control on the ride home.  On top of which he feels that it is interfering with his daily quality of life.  He was previously diagnosed with BPH and was on Proscar and Flomax.  He was however fairly inconsistent with his compliancy and would have remtting symptoms accordingly.

BPH as we know is benign in terms of mortality but has significant associated issues such as those had by the patient above.  The question I came across was the thoughts in using dual therapies versus single therapy.

The American Urology Association has an algorithm for which to follow and decide upon treatment and that can be found here.

Therapies are therefore categorized into two classes between alpha-1-adrenergic antagonists and 5-alpha-reductase inhibitors.  This study showed that combination therapy had proven long term benefit over either alone.  There were drops in rates of comorbidities such as incontinence, renal insufficiency, and UTI with one therapy and even further with combination therapies.  The fact that over the long term invasive therapy was avoided at greater rates was also a plus.  Considering the risks involved with any invasive procedure, not to mention risk of loss of sexual function.

So What Now:

<!--[if !supportLists]-->1)      <!--[endif]-->BPH although not likely life threatening can be seen in 50% of the men by the age of 50.

<!--[if !supportLists]-->2)      <!--[endif]-->The symptoms associated with BPH affect the quality of one's life dramatically.

<!--[if !supportLists]-->3)      <!--[endif]-->Accurate assessment through AUA guidelines help define severity and treatment route

<!--[if !supportLists]-->4)      <!--[endif]-->Dual therapy should be considered to provide maximum benefit for the longest time frame.